Never Forgotten

Author

Anthony Picot

🔗 Source: UNICEF – Stillbirth Data

The global state of stillbirths

Their names could be Ashley, Fatou or Luis. They are among the millions of babies who are stillborn every year, gone before taking a first breath, before being held, seen, or even named. Each day, more than 5,000 families experience the devastating loss of a baby during pregnancy or birth.

According to UNICEF, a stillbirth is defined as the death of a baby at 28 weeks or more of gestation, with no signs of life at birth. And yet, most of these tragedies could be prevented, if only mothers had access to quality care during pregnancy and delivery.

Despite progress in some regions, stillbirths remain a silent and invisible crisis, heavily affecting low- and middle-income countries. This dashboard sheds light on where stillbirths happen, how they are connected to healthcare access, and why urgent action is still needed.

Pregnant woman - stillbirth awareness

This map displays the global stillbirth rate per 1,000 births in 2021.
The highest rates are concentrated in Sub-Saharan Africa and South Asia, highlighting critical inequalities in access to maternal healthcare.

1 Stillbirth rate by region (2021)

Stillbirths are more than numbers, they are a powerful sign of how well a health system protects mothers and babies.
This chart shows the average stillbirth rates across different world regions in 2021, helping us understand where the burden is highest.

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2 The highest and lowest stillbirth rates

Not all countries face the same reality. This chart compares the 10 countries with the highest and lowest stillbirth rates in 2021.

At the bottom of the chart, countries like Monaco, Japan, and Norway report fewer than 2 stillbirths per 1,000 births, thanks to strong healthcare systems and universal access to prenatal care.

But at the other end, Guinea-Bissau, Somalia, and Afghanistan show rates over 25 stillbirths per 1,000 births. These are largely countries affected by conflict, poverty, and weak health infrastructures.

This contrast tells us something crucial: stillbirths are not inevitable, they’re a matter of inequality.

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Countries like Norway, Japan, and Monaco report fewer than 2 stillbirths per 1,000 total births. In contrast, Guinea-Bissau, Somalia, and the Democratic Republic of Congo face stillbirth rates over 25 per 1,000 births, reflecting deep inequalities in access to quality care.

Several countries with high rates are concentrated in Sub-Saharan Africa, where fragile health systems, conflict, and poverty still threaten maternal and newborn health.

3 Evolution of stillbirths over time (2000–2021)

Looking back at the past two decades, this line chart shows the evolution of stillbirth rates from 2000 to 2021.

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The chart reveals a clear downward trend: stillbirth rates have decreased in every region since 2000. The global average has dropped from over 14 to just above 10 stillbirths per 1,000 births in 2021.

But while high-income regions like Europe and North America have maintained low rates, Africa, though improving, still struggles with rates nearly five times higher than Europe.

This progress shows what’s possible. But it also reminds us that not all regions are benefiting equally, and some still need urgent support.

4 The impact of healthcare on stillbirths (2021)

Healthcare access plays a major role. This scatter plot reveals a strong link between the number of hospital beds per 1,000 people and the stillbirth rate in each country.

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Generally, the more healthcare capacity a country has, the fewer stillbirths occur. Yet this is not a simple equation. Behind each dot lies a web of other contributing factors:

🔍 Contributing Factors

  • 🏡 Socio-economic conditions: rural residence, migration status, low income
  • ☀️ Environmental exposure: extreme heat, air pollution (indoor and outdoor)
  • 🦠 Maternal health risks: infections (malaria, syphilis, HIV), diabetes
  • 🚨 Pregnancy complications: fetal growth restriction, lack of emergency care
  • 👶 Age and vulnerability: teenage mothers, domestic violence
  • 🚬 Behavioural factors: lack of support, unhealthy lifestyle

These factors often intersect, especially in low-resource settings.

5 Stillbirths and economic inequality

To go further, let’s explore the connection between national wealth and stillbirths.

This boxplot groups countries by income level and shows their average stillbirth rates in 2021. The differences are striking:

Low income (≤ $1,085): median ≈ 20 stillbirths

Lower-middle ($1,086–$4,255): median ≈ 10

Upper-middle ($4,256–$13,205): median ≈ 7

High income (> $13,205): median ≈ 3

This dramatic decline confirms that economic development plays a crucial role in reducing stillbirths — but it’s not just about money. It’s about how resources are used to deliver care where it’s needed most.

This chart shows how a country’s wealth is linked to the number of stillbirths. Countries with higher GDP per person tend to have lower stillbirth rates

This pattern highlights an important message: money helps — but only when it’s invested in people. Countries with strong health systems, prenatal care, and access to hospitals see much better outcomes.

There are some exceptions. A few richer countries still have relatively high stillbirth rates, while some poorer ones do better than expected. This shows that economic growth is important, but it’s not enough. What matters most is how countries use their resources to protect mothers and babies.

Stillbirths are not just a medical issue

They reflect deep inequalities in access to care, income, and global attention.

Understanding these patterns is the first step to changing them. By recognizing where progress is happening — and where it’s still needed — we can help shape a future where no life is forgotten before it begins.

Learn more on UNICEF’s official page

Source: United Nations Inter-agency Group for Child Mortality Estimation (UN IGME),

Never Forgotten: The situation of stillbirth around the globe, United Nations Children’s Fund, New York, 2023.

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